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75% of chronic pulmonary disease cases linked to childhood illnesses and parental smoking

The findings were published in The Lancet journal this week.

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NEW RESEARCH HAS found a significant link between chronic obstructive pulmonary disease (COPD) and illnesses someone had as a child and the exposure to parents smoking.

While first-hand smoking remains the biggest factor of COPD, the study found that childhood illnesses – such as asthma, bronchitis, pneumonia and eczema – and exposures to parents smoking are also linked to the disease.

COPD is expected to be the third largest cause of death globally by 2030.

The findings were published this week in The Lancet Respiratory Medicine journal.

A second study in the journal also suggests that there could be a window of opportunity during childhood to reduce the risk of poor lung function in later life.

Both studies identified pathways of how lung function changes over a lifetime, which are associated with different risk factors and disease risk in later life.

“These findings highlight the importance of preventing both early life adverse exposures that could lead to poorer lung growth, and adult risk factors contributing to accelerated lung decline,” Professor Shyamali Dharmage of University of Melbourne’s School of Population and Global Health said.

The study

In the first study, 2,438 participants from the Tasmanian Longitudinal Health Study were tracked from childhood to the age of 53.

Lung function was measured at the ages of seven, 13, 18, 45, 50 and 53 years old. Participants’ exposure to various risk factors was also recorded.

The authors found six different pathways describing how long function changes with age.

Three of these were associated with COPD – the group with below average lung function in early life and a quick decline in lung function in later life, those with persistently low lung function, and those with below average lung function.

Combined, these were linked to an estimated 75.2% of all cases of COPD occurring at the age of 53.

These three pathways were linked to childhood asthma, bronchitis, pneumonia, allergic rhinitis, eczema, parents having asthma or smoking, and the participants themselves smoking or having asthma.

In the second study, 2,632 participants were tracked from birth to 24 years old and their lung function was measured.

The authors found that around three-quarters of infants aged one to six months with poor lung function improved throughout their childhood. This indicated a window of opportunity to increase lung function and potentially reduce the risk of COPD in later life.

Recommendations

The authors said that it is important to reduce parental smoking, encourage immunisation, and avoid smoking to promote healthy lung functions and minimise COPD risk.

In addition, they said ensuring that all people with asthma have appropriate treatment may be vital to preserving lung function.

Commenting on the findings, Professor Erika von Mutius of Ludwig Maximilians University, Germany said: “COPD is a common condition in adults, with high morbidity and mortality.

“COPD has been mainly attributed to active smoking in adulthood, but some patients are diagnosed with COPD in the absence of a smoking history and only 20-35% of smokers develop COPD.

Taken together, these findings clearly points towards the importance of early life for the development of COPD.

“Importantly, maternal smoking and childhood asthma not only adversely affected early lung function, but predisposed children to more rapid lung function decline if they still suffered from asthma or actively smoked as adults.”

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